Provider Demographics
NPI:1558519140
Name:KARL A. SPECTOR MD PA
Entity Type:Organization
Organization Name:KARL A. SPECTOR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SPECTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-515-6774
Mailing Address - Street 1:602 S ATWOOD RD
Mailing Address - Street 2:UNIT 200A
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4172
Mailing Address - Country:US
Mailing Address - Phone:410-515-6774
Mailing Address - Fax:
Practice Address - Street 1:602 S ATWOOD RD
Practice Address - Street 2:UNIT 200A
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4172
Practice Address - Country:US
Practice Address - Phone:410-515-6774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0055143207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH08108Medicare UPIN